Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study

Yeonjung Ha; Tae Hun Kim; Jae Eul Shim; Sunghyun Yoon; Mi Jung Jun; Young Ho Cho; Han Chu Lee

doi:10.1007/s12072-019-09994-9

Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study

Yeonjung Ha, Tae Hun Kim, Jae Eul Shim, Sunghyun Yoon, Mi Jung Jun, Young Ho Cho, Han Chu Lee

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Background: Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity. Methods: Patients undergoing surgery for early-stage HCC were prospectively enrolled. The CTC numbers were determined using a tapered slit platform, which detects CTCs based on the cell size and morphology. Survival and recurrence were evaluated, and Cox proportional hazards models were used to demonstrate the prognostic significance of CTC. Results: Of 105 patients, 25 had increased CTC numbers after surgery (ΔCTC > 0, defined as positive) and a significantly higher level of recurrence (p = 0.042). A positive ΔCTC was seen to be an independent predictor of recurrence (hazard ratio 2.28), along with hepatitis B virus infection, alanine aminotransferase level, and the presence of satellite nodules (all p < 0.05). Subgroup analyses showed that a positive ΔCTC was associated with lower survival and higher recurrence among patients with low alpha-fetoprotein levels and cirrhosis (all p < 0.05). Conclusion: Calculation of ΔCTC based on the physical properties of the cells is predictive of recurrence in patients with early HCC undergoing surgery.

Original language	English
Pages (from-to)	726-735
Number of pages	10
Journal	Hepatology International
Volume	13
Issue number	6
DOIs	https://doi.org/10.1007/s12072-019-09994-9
State	Published - 1 Nov 2019

Bibliographical note

Funding Information:
This work was supported in full by the Fundamental R&D Programs for Core Technology of Materials, Ministry of Trade, Industry and Energy (Grant Number: 10078295). The funder had no role in study design, data collection, analysis, and interpretation, writing of the report, or decision to submit the article for publication.

Publisher Copyright:
© 2019, Asian Pacific Association for the Study of the Liver.

Keywords

Circulating tumor cells
Hepatocellular carcinoma
Nanomedicine
Recurrence
Survival

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study",

abstract = "Background: Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity. Methods: Patients undergoing surgery for early-stage HCC were prospectively enrolled. The CTC numbers were determined using a tapered slit platform, which detects CTCs based on the cell size and morphology. Survival and recurrence were evaluated, and Cox proportional hazards models were used to demonstrate the prognostic significance of CTC. Results: Of 105 patients, 25 had increased CTC numbers after surgery (ΔCTC > 0, defined as positive) and a significantly higher level of recurrence (p = 0.042). A positive ΔCTC was seen to be an independent predictor of recurrence (hazard ratio 2.28), along with hepatitis B virus infection, alanine aminotransferase level, and the presence of satellite nodules (all p < 0.05). Subgroup analyses showed that a positive ΔCTC was associated with lower survival and higher recurrence among patients with low alpha-fetoprotein levels and cirrhosis (all p < 0.05). Conclusion: Calculation of ΔCTC based on the physical properties of the cells is predictive of recurrence in patients with early HCC undergoing surgery.",

keywords = "Circulating tumor cells, Hepatocellular carcinoma, Nanomedicine, Recurrence, Survival",

author = "Yeonjung Ha and Kim, {Tae Hun} and Shim, {Jae Eul} and Sunghyun Yoon and Jun, {Mi Jung} and Cho, {Young Ho} and Lee, {Han Chu}",

note = "Funding Information: This work was supported in full by the Fundamental R&D Programs for Core Technology of Materials, Ministry of Trade, Industry and Energy (Grant Number: 10078295). The funder had no role in study design, data collection, analysis, and interpretation, writing of the report, or decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2019, Asian Pacific Association for the Study of the Liver.",

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doi = "10.1007/s12072-019-09994-9",

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T1 - Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma

T2 - a prospective study

AU - Ha, Yeonjung

AU - Kim, Tae Hun

AU - Shim, Jae Eul

AU - Yoon, Sunghyun

AU - Jun, Mi Jung

AU - Cho, Young Ho

AU - Lee, Han Chu

N1 - Funding Information: This work was supported in full by the Fundamental R&D Programs for Core Technology of Materials, Ministry of Trade, Industry and Energy (Grant Number: 10078295). The funder had no role in study design, data collection, analysis, and interpretation, writing of the report, or decision to submit the article for publication. Publisher Copyright: © 2019, Asian Pacific Association for the Study of the Liver.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Background: Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity. Methods: Patients undergoing surgery for early-stage HCC were prospectively enrolled. The CTC numbers were determined using a tapered slit platform, which detects CTCs based on the cell size and morphology. Survival and recurrence were evaluated, and Cox proportional hazards models were used to demonstrate the prognostic significance of CTC. Results: Of 105 patients, 25 had increased CTC numbers after surgery (ΔCTC > 0, defined as positive) and a significantly higher level of recurrence (p = 0.042). A positive ΔCTC was seen to be an independent predictor of recurrence (hazard ratio 2.28), along with hepatitis B virus infection, alanine aminotransferase level, and the presence of satellite nodules (all p < 0.05). Subgroup analyses showed that a positive ΔCTC was associated with lower survival and higher recurrence among patients with low alpha-fetoprotein levels and cirrhosis (all p < 0.05). Conclusion: Calculation of ΔCTC based on the physical properties of the cells is predictive of recurrence in patients with early HCC undergoing surgery.

AB - Background: Previous studies evaluating association between circulating tumor cells (CTCs) and clinical outcomes in hepatocellular carcinoma (HCC) have shown inconsistent results due to suboptimal detection methods and patient heterogeneity. Methods: Patients undergoing surgery for early-stage HCC were prospectively enrolled. The CTC numbers were determined using a tapered slit platform, which detects CTCs based on the cell size and morphology. Survival and recurrence were evaluated, and Cox proportional hazards models were used to demonstrate the prognostic significance of CTC. Results: Of 105 patients, 25 had increased CTC numbers after surgery (ΔCTC > 0, defined as positive) and a significantly higher level of recurrence (p = 0.042). A positive ΔCTC was seen to be an independent predictor of recurrence (hazard ratio 2.28), along with hepatitis B virus infection, alanine aminotransferase level, and the presence of satellite nodules (all p < 0.05). Subgroup analyses showed that a positive ΔCTC was associated with lower survival and higher recurrence among patients with low alpha-fetoprotein levels and cirrhosis (all p < 0.05). Conclusion: Calculation of ΔCTC based on the physical properties of the cells is predictive of recurrence in patients with early HCC undergoing surgery.

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KW - Hepatocellular carcinoma

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KW - Recurrence

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Circulating tumor cells are associated with poor outcomes in early-stage hepatocellular carcinoma: a prospective study

Abstract

Bibliographical note

Keywords

UN SDGs

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